by Michael Arevalo, Psy.D., PMP on October 28, 2025
In 2024, the global healthcare revenue cycle management (RCM) market was valued at over $343 billion, according to Grand View Research. By 2033, that number is projected to grow to $894 billion — a compound annual growth rate of 11.12%.
Why such dramatic growth in less than a decade?
The complexity of managing unique insurance payer rules, ever-changing coding requirements, and clinical documentation requirements is likewise growing. In this environment, technology-focused behavioral health RCM companies are playing a critical role in helping providers improve their revenue cycle performance.
Rather than deliver outsourced coding, billing, and collections services, these companies are providing behavioral health organizations with software platforms that help power better in-house and outsourced RCM by automating claims management, improving reimbursement, and ensuring compliance.
With demand for behavioral health care rising and provider shortages persisting, organizations cannot afford to manage the complexities of revenue cycle manually. Doing so increases the risk of denials and lost payments. The path to improved performance begins with choosing a behavioral health software solution — and that starts with asking the right questions.
Here are key considerations to raise with potential behavioral health RCM software vendors to get the most out of your technology investment.
Questions About Behavioral Health RCM Technology Solutions
What kinds of technology integrations do you offer?
Ideal answer: Our RCM capabilities are embedded into a comprehensive electronic health record (EHR), which uses Fast Healthcare Interoperability Resources (FHIR) to ensure smooth interoperability, workflows, and collaboration.
Layering technologies on top of one another can lead to time-consuming hurdles and inefficient workflows. Look for behavioral health RCM companies with strong EHRs and integrated RCM capabilities. By combining an all-in-one solution and effective integrations, you can better manage your administrative, clinical, and RCM needs from a single central resource.
Does your behavioral health technology provide reporting and analytics?
Ideal answer: With our advanced behavioral health EHR with integrated RCM solutions, you can access an intuitive dashboard with data based on industry-specific key performance indicators (KPIs), such as claim denial rates, first-pass claim rates, authorization utilization vs. approved units, documentation completeness rates, denial rates by category, collection percentages, days in accounts receivable by payer, and noncompliance rates.
Organizations need insight into their clinical and RCM performance to effectively manage their mental health billing process. Without access to relevant KPIs, behavioral health organizations risk making the wrong RCM decisions that could waste time, money, and resources. Analyzing data through an advanced EHR enables teams to quickly pinpoint and address gaps that could be impacting their revenue.
Does your technology support telehealth billing?
Ideal answer: Clients can set and attend telehealth visits directly through their easy-to-use EHR portal, while providers can personalize virtual care and improve documentation by automating notetaking during secure Zoom-integrated visits.
In 2023, telehealth comprised 58% of all mental health visits — and demand for virtual care shows no sign of stopping. When scoping out potential tech-based behavioral health RCM companies, ensure they offer not only integrated telehealth services, but also telehealth billing capabilities. Automated virtual notetaking, for example, streamlines the documentation process, helping ensure claims are accurate and complete before submission.
Questions About Staying Current With a Shifting Landscape
How frequently do you update your behavioral health coding libraries and payer rules?
Ideal answer: Our RCM engine is regularly updated to reflect the latest payer and regulatory requirements, preventing inaccuracies that can lead to costly payment delays or denials.
Fast behavioral health reimbursement depends on accurate coding, yet organizations must juggle numerous coding standards and complicated guidance, often leading to errors. That’s why it’s critical to adopt EHR technology — backed by behavioral health RCM experts — that keeps pace with a constantly shifting coding and billing environment.
How do you ensure compliance with payer rules and help prevent claim denials?
Ideal answer: Our advanced EHR comes with integrated compliance tracking solutions.
Like behavioral health reimbursement and coding procedures, compliance rules are constantly shifting. EHRs with embedded compliance checklists help teams avoid errors that could result in fines or delay reimbursement.
Similarly, look for EHRs with proactive claim workflows. The right technology-based behavioral health RCM companies will offer systems with preloaded claim checks that automatically flag issues before submission. Claim-scrubbing capabilities streamline the process even further, helping organizations achieve cleaner and faster claim submissions.
Can your system support value-based care models and reporting?
Ideal answer: Our EHR supports value-based care by linking clinical outcomes data (e.g., PHQ-9, GAD-7, ASAM scores) to billing and reporting dashboards. This enables transparent performance tracking, outcome reporting for CCBHC and Medicaid quality metrics, and accurate documentation for incentive-based reimbursement.
Value-based care requires organizations to submit detailed documentation alongside behavioral health reimbursement claims. Be sure to adopt an EHR that supports this shift in focus, enabling accurate, fast documentation and clear outcome tracking to cover all the model’s billing requirements.
Questions About Support and Service
What experience do you have with behavioral health reimbursement billing processes?
Ideal answer: Our technology is specifically built for the behavioral health and IDD space, offering key features that behavioral health and IDD providers and organizations require. Our team has experience with behavioral health reimbursement, such as Medicaid FFS and MCO billing, IDD waiver programs, and crisis/CCBHC funding models.
Too often, EHRs are built for the broader healthcare landscape, so behavioral health and IDD organizations spend unnecessary time tracking down the features they need for their specific care delivery needs. To ensure seamless workflows and results, look for a system that’s tailor-made for behavioral health reimbursement and mental health billing processes.
Do you offer coding support or guidance tailored to behavioral health?
Ideal answer: Since our EHR is made for the behavioral health care space, our team of experts is on hand to support with coding updates, billing, and overall RCM. We have in-depth CPT and HCPCS expertise — including H2019, H0032, 90837, 90846/47, 90785 — and we can assist your team in monitoring policy bulletins.
Accurate coding is vital for fast, accurate reimbursement and compliance. The behavioral health EHR vendor you partner with should not only offer features that support proper documentation, workflows, and other RCM-boosting capabilities, but also help your organization stay up to date with evolving reimbursement requirements.
Do you provide dedicated account management and ongoing training?
Ideal answer: Our team is always on standby to help you make the most of your behavioral health EHR investment and continually optimize your RCM capabilities.
Search for behavioral health RCM companies that offer low- or no-code technologies so your team can implement and use the solution with little to no IT support required. Also, be sure that your selected vendor provides personalized support from onboarding to implementation and beyond.
One EHR, Endless Benefits
In a crowded market of healthcare technologies, the right tech-focused behavioral health RCM companies will offer fully integrated solutions that comprehensively solve your RCM challenges and drive faster, accurate payments. Ask potential behavioral health software vendors for references from organizations they’ve partnered with, as client success stories can tell you a lot before adopting new technology.
And don't settle for a solution with only some of the features you need. Instead, find a technology provider like Core Solutions. Core’s Cx360 Enterprise EHR platform streamlines workflows, enables effective collaboration, provides access to advanced data analytics, and offers artificial intelligence (AI)-powered tools and other integrated solutions that can enhance your organization’s RCM.
In a world inundated with complexity, the Cx360 Enterprise behavioral health platform makes things easy. Reach out for a demo today.
